Cindy, I had a similar case a couple of years ago. It turned out that the mother was a *secret* smoker. Yes, we did ask her about smoking, but she denied it, and it was only after she had weaned that somebody saw her smoking and discovered that she had been doing it all along. I know that it is possible to smoke and nurse, (not that anybody would recommend the practice!) but in a case like this when the baby was not gaining well, it was definately not a good idea.
BTW, what worked for this mother was to pump on both sides, then nurse as long as the baby wanted (to make sure that she got the higher calorie hindmilk,) and then feed the pumped with an oral syringe.

Norma Ritter, LLLL, IBCLC
"If not now, when? If not us, who?"
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